International heart journal最新文献

Low BMI has been reported to be associated with atrial fibrillation (AF) recurrence post-ablation, as well as with cardiovascular events and mortality. However, the previous studies have not fully accounted for baseline factors including age, nutritional status, anemia, and cardiac function. Thus, the potential risks inherent in patients with AF and low BMI remain unclear. AF patients who underwent primary ablation were enrolled. To exclude the effect of baseline factors including age, nutritional status, anemia and cardiac function, propensity score-matching was performed. The incidence of composite of heart failure (HF) hospitalization and all-cause death among the patients stratified by BMI was investigated. We finally analyzed 2396 patients. Low BMI was defined as < 18.5 kg/m² and normal/high BMI as ≥ 18.5 kg/m². The low and normal/high BMI groups consisted of 120 patients after 1:1 propensity score-matching, respectively. In propensity score-matched population, normal/high BMI had higher risk of late arrhythmia recurrence post-ablation than low BMI in persistent AF, while no significant difference in paroxysmal AF. Kaplan-Meier analysis showed incidence of the composite endpoint was significantly higher in patients with low BMI than those with normal/high in the overall and propensity score-matched populations (Log-rank P < 0.001 and P = 0.024, respectively). Cox proportional hazard analysis revealed low BMI had significantly and independently higher risk of the composite endpoint (HR = 2.43; 95% CI = 1.098-5.374). Despite a lower recurrence rate, patients with low BMI showed a paradoxically higher incidence of HF hospitalization and all-cause mortality, highlighting the need for further investigation into potential interventions targeting low BMI patients.

Hypertrophic cardiomyopathy (HCM), recognized as the most prevalent inherited heart condition, is found in about 0.2% to 0.5% of the population globally. Recent years have witnessed a notable surge in HCM-related scholarly investigations. The aim of this study was to delineate the trajectory of HCM research over the preceding decade through a comprehensive bibliometric analysis. Utilizing the Web of Science Core Collection (WoSCC) database, we retrieved data on HCM-related studies conducted between 2013 and 2023. The acquired bibliographic data were methodically processed and examined using VOSviewer and CiteSpace software. A remarkable escalation in HCM-related publications was observed throughout the last decade. The United States emerged as the foremost contributor, amassing a total of 2,479 publications and exhibiting the most extensive international collaborative efforts. Mayo Clinic was recognized for its significant contributions and leadership in research collaborations within the HCM domain. Dr. Iacopo Olivotto stood out as a leading figure in the field, authoring 152 articles over this period. The decade was marked by robust transnational collaborations among countries, institutions, and authors. Notably, the publications 'Circulation,' 'JACC,' and 'European Heart Journal' recorded the most citations, receiving 30,736, 26,769, and 13,192 citations, respectively. Our study presents the first in-depth bibliometric and visual exploration of the global HCM research landscape, providing an invaluable reference for clinical researchers engaged in this field.

Acute aortic dissection (AD) and pulmonary thromboembolism (PE) are life-threatening conditions requiring timely diagnosis. In Japan, large-scale validation studies of administrative data for these diagnoses are limited. It is required to validate the accuracy of International Classification of Diseases, 10th Revision (ICD-10) codes for acute AD and PE in the Diagnosis Procedure Combination (DPC) database using medical chart review as the reference standard.We reviewed DPC data from the University of Tokyo Hospital (April 2018-March 2024). Patients with I710 (AD) or I260/I269 (PE) listed in key diagnosis fields were identified. Chart reviews confirmed diagnoses, and 199 randomly selected patients without AD/PE codes served as negative controls. Sensitivity, specificity, and positive predictive value (PPV) were calculated.Among 10,483 records, 54 had DPC-coded AD and 71 had PE. Chart review confirmed 47 cases of acute AD and 48 of acute PE. No false negatives were found among controls. For acute AD, sensitivity was 100.0% (95% CI: 92.5-100.0), specificity 96.6% (93.1-98.6), and PPV 87.0% (75.1-94.6). For acute PE, sensitivity was 100.0% (92.6-100.0), specificity 89.6% (84.9-93.3), and PPV 67.6% (55.5-78.2).ICD-10 codes in the DPC database accurately identify acute AD and PE, with particularly high sensitivity. While PPV for acute PE is lower, likely due to inclusion of chronic conditions, DPC data can be cautiously used for research and surveillance in academic hospital settings. Multicenter validation is needed to ensure broader generalizability.

Acute myocardial infarction (AMI) impacts the regenerative capacity of hematopoietic stem and progenitor cells (HSPCs) following injury, but it remains unclear if these functional alterations persist beyond the initial ischemic event.A minimally invasive mouse model of recurrent myocardial infarction was established using echocardiography-guided coronary interventions. Bone marrow HSPCs were quantified and analyzed for proliferation by flow cytometry and BrdU incorporation. Peripheral blood leukocytes and inflammatory cytokines (IL-6, G-CSF) were measured by flow cytometry and ELISA. Bone marrow extracellular TGF-β1 was assessed by ELISA, and its functional role was evaluated through antibody-mediated inhibition.The minimally invasive infarction model was validated through electrocardiography, cardiac biomarkers, echocardiography, and cardiac pathology staining. Fourteen days post-I/R or sham treatment, bone marrow hematopoiesis returned to a steady state with no significant differences in Lin^-Sca-1⁺c-Kit⁺ (LSK), hematopoietic stem cell (HSC), multipotent progenitor (MPP), and granulocyte/macrophage progenitor (GMP) cell numbers. However, after a secondary ischemic challenge, there was a dampened reactive hematopoiesis indicated by reduced HSPCs, compared to the first ischemic event. BrdU incorporation analysis showed decreased HSPC proliferation activity during the reparative phase after initial ischemic challenge, linking dampened hematopoiesis to decreased HSPCs proliferation. Additionally, early recurrent infarct mice had fewer neutrophils released in peripheral blood and lower serum IL-6 and G-CSF levels. Elevated TGF-β1 levels were detected in bone marrow extracellular fluid during the reparative phase of cardiac-ischemic injury, and inhibiting TGF-β1 reversed the dampened reactive hematopoiesis of HSPCs in an early recurrent MI setting.Our data suggest that initial myocardial ischemia challenges blunt bone marrow reactive hematopoiesis to subsequent ischemic stress, with decreased HSPC proliferation contributing to diminished regenerative capacity. TGF-β1 in bone marrow extracellular fluid may mediate this decreased HSPC proliferation.

Essential hypertension (EH) and hypertrophic non-obstructive cardiomyopathy (HNCM) are representative conditions associated with left ventricular hypertrophy (LVH). We compared the severity and distribution of LVH between these two conditions.This study included 44 patients with EH and 79 with HNCM exhibiting precordial negative T-waves (NTs) without LV heart failure. Electrocardiographic assessments included measurements of SV1 + RV5 and the maximum depth of NTs, and routine echocardiographic indices were measured.The SV1 + RV5 and maximum depth of NTs were greater in HNCM than in EH. A correlation was found between these two indices in both groups, with the correlation slope being 4.8 times steeper in the HNCM group. The difference in correlation slopes was considered to reflect the degree of myocardial ischemia. The maximum depth of NTs was predoinantly recorded in the V6 lead in EH, and the V4 and V5 leads in HNCM. Interventricular septal thickness (IVST) was greater in HNCM, whereas LV posterior wall thickness (PWT) was higher in EH. The IVST/PWT ratios were calculated as 0.91 ± 0.10 in EH and 1.20 ± 0.35 in HNCM (P< 0.0001). No significant difference was found in the LV mass index between the two groups. The areas under the receiver operating characteristic curve for the maximum depth of precordial NT and the maximum depth of precordial NT/SV1 + RV5 ratio were 0.967 and 0.952, respectively.LVH was similar between EH and HNCM; however, myocardial ischemia was more severe in HNCM than in EH. The distribution pattern of LVH differed markedly between these two conditions.

Cardiovascular-kidney-metabolic (CKM) syndrome is associated with numerous adverse health outcomes. However, the relationship between the different stages of CKM syndrome and relative muscle loss risk remains unclear. This cross-sectional study evaluated the association between CKM syndrome and relative muscle loss, including 4,322 participants from the National Health and Nutrition Examination Survey conducted in 2011-2018. The Foundation for the National Institutes of Health defined relative muscle loss as characterized by the appendicular lean mass adjusted by the body mass index. We constructed weighted multivariate logistic regression models to examine the association between different stages of CKM syndrome and relative muscle loss. Furthermore, we explored the effects of its individual components on the risk of relative muscle loss. Of 4,322 participants, 397 (9.0%) were diagnosed with relative muscle loss. Within the multivariate model, participants in CKM syndrome stages 1-4 exhibited significantly higher risks for relative muscle loss compared with those in stage 0, with odds ratios (95% confidence intervals) of 3.91 (1.96-7.81), 4.16 (2.08-8.32), 4.95 (2.37-10.34), and 7.74 (2.61-22.92), respectively. Notably, metabolic disorders were most strongly associated with relative muscle loss. Participants with clinical cardiovascular disease, chronic kidney disease, and metabolic disorders had significantly higher risks of relative muscle loss than those without these conditions. These findings remained robust across various subgroup analyses.Patients with CKM syndrome stages 1-4 exhibited a higher risk of relative muscle loss than those in stage 0. Moreover, metabolic disorders may be the most significant risk factor for relative muscle loss.

The aging population has led to an increase in nonagenarians undergoing percutaneous coronary intervention (PCI). Nonagenarian patients are at risk for geriatric complications, including delirium, which can worsen clinical outcomes. However, research on delirium and its clinical implications in nonagenarians with acute coronary syndrome (ACS) following PCI is limited.This retrospective observational cohort study analyzed data from 307 nonagenarians with ACS who underwent PCI. Delirium was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders-5 criteria. Prevalence and prognostic impact of delirium during hospitalization were investigated.Delirium occurred in 85 patients (27.7%) during hospitalization. Patients with delirium had longer hospital stays and lower discharge rates to home or the same location as prior to hospitalization compared to patients without delirium. However, in-hospital mortality rates were comparable between the groups. Over a median follow-up of 480 days, no significant differences were found in all-cause mortality between the two groups.Delirium was common among nonagenarians with ACS following PCI. While delirium was associated with length of hospital stays and discharge destination, it was not linked to survival rates. Prevention, early detection, and effective management of delirium are important for optimizing care in super-aged patients following PCI.